We could re-write

> Autism spectrum disorder (ASD) is characterized by [...] restricted interests and repetitive behaviors.

as

> ASD is characterized by an ability to focus intently on an area of special interest, developing an unusually detailed level of knowledge of that topic.

There's always a tension with efforts to depathologise things, because some people do need support and the way they get support at the moment is via diagnosis.

> ASD is characterized by an ability to focus intently on an area of special interest, developing an unusually detailed level of knowledge of that topic.

However, this is not true. It doesn't apply to all people with ASD. I volunteered with adults with ASD about ten years ago. One person in the group really had a special interest fixation (a person), but he didn't know more than the average person would know after reading a single biography. He was barely able to read or remember complex facts, so I don't think he had the ability to develop an unusually detailed level of knowledge of that topic or any other. The rest didn't have any memorable interests, but I guess it's also possible that it wasn't cultivated in them.

It's also true that none of the symptoms of autism apply universally.

I'm good friends with an autistic man, he's got a special interest for a certain branch of mathematics and swing dance. He's also great with regards to social interaction, he's seemed to keep close connections with every person he comes across when he's traveled.

There's a saying that "if you've met one person with autism, you've met one person with autism", symptoms present differently in everyone and they're highly responsive to environment. As a trend I'd say special interests are probably a decent contender for a hallmark, probably along with language difficulty and eye contact avoidance.

The negative characteristics don't apply to everyone with ASD either.

Even more neutral would be to call it Autism Spectrum or Autism Spectrum Condition, not "Disorder".

"Disorder" is a medical term for "badness", especially weird to apply to a condition that is notable for its extreme mental... orderliness.

I never understood autism to be noted for extreme orderliness in all cases. Orderliness from what I understand is just one of multiple possible symptoms that, collectively, are termed as autism.

(You can be extremely orderly and not have autism, for example, if you had Obsessive Compulsive Personality Disorder which is different from the more familiar OCD.)

The thing is, while there may be a broader thing for which “Autism Spectrum Condition” is the most accurate label, modern psychiatry can only diagnose a disorder, and that's not just an arbitrary artifact of naming. We don't have the understanding of the mechanics beneath most psychological conditions, including Autism, to diagnose them other than by the combination of social dysfunction and accompanying factors. To the extent that there is an Autism or Autism-like-condition which is not a “badness” in the concrete conditions in which it is experienced it is outside the scope of what we can meaningfully discern.

> "Disorder" is a medical term for "badness", especially weird to apply to a condition that is notable for its extreme mental... orderliness.

I don't see anything weird about that; are you suggesting that there is no extreme of inflexible attachment to order which would be ever be bad?

Autism is understood to be a neurodevelopmental condition rather than a psychiatric one. This would make sense given sensory differences are common and that autism has comorbidity with prosapognosia.

There's a movement to reframe things like autism as neurodiversity rather than strictly a disorder. I suppose the emphasis in that case would instead be on things people can do well, not what they do wrong by everyone else's standard.

The neurodiversity movement/argument really gained strength as improvements in diagnostic instrument sensitivity produced diagnoses with less profound forms of autism.

While I respect the message of neurodiversity, it has often come at the expense of individuals with profound autism where one would be hard-pressed to not apply labels like disability, impairment, and such. Profound autism represents a substantial proportion of the autistic spectrum, but they are the least able to represent and advocate for themselves.

I think it's difficult with autism because autism applies to people who cannot feed themselves as well as people who would be defined by others as 'quirky'. There's no differentiation, so it'd be like calling all men disabled because some men are disabled. Of course, calling all men completely healthy isn't right either. There's no granularity.

These days it's also a lot of pretty much random people who were sent to the school psychologist for some reason or other, plus a bunch of people who went to see a GP for things like a runny nose and were hoodwinked into a couple of psychiatric diagnoses they'll never get rid of, plus a lot of depressive narcissists who cling to their unfounded diagnosis to feel better about themselves, and the doctors play along because it's the easiest way to deal with them.

I suspect >90% of so called ASD cases have little real clinical basis these days and the entire disorder looks very fishy.

The two should be treated differently.

Many are diagnosed with “autism”, seemingly not for any lack of ability, but præferences the diagnostician does not necessarily agree with.

I also object to “neuro-” morpheme. The diagnosis of these conditions are psychiatric, not neurological, and in many cases where such a diagnosis was made, there is nothing neurologically unusual that could be found, but in some cases there is.

Autism is simply with the current understanding not a neurological, but a psychiatric disorder. — the understanding may grow such that it might become one one day, but that is not the current level of understanding, and such understanding would most likely lead to the realization that all which is currently grouped under “autism”, has many different underlying neurological causes.

Unless you believe in mind-body dualism, then your objection of the neuro morpheme is on shaky ground.

All psychiatric disorders ARE neurological...i.e. is rooted in the brain and associated systems. Moreover, there are plenty of neurological differences between ASD and TD groups, both at the cellular and morphological levels. However, a lot of the morphological differences are too small, and heterogeneity too large, to be useful as a means of diagnosis.

The problem with your reasoning is that you assume that what psychiatrists group together based on behavior and culture must share single identifiable neurological causes.

It's entirely possible that there is nothing neurologically objectively different about an autistic person from a non-autistic person, and that it's simply a cultural quirk that led to it; this has been the case with many historical diagnoses.

In fact, I would argue that this is not simply possible, but likely, given that usually, if such a neurological discriminant exist, it is typically quickly found. That they have searched for so long without being able to find it, is indicative of a nonexistence.

No where did I assume a 1-1 correspondence between psychiatric label and neurological cause. Many disorders likely show variation precisely because they have different underlying causes....much like a car might not start for a number of reasons, including faulty wiring, bad battery, bad starter, no fuel, etc. It is also this heterogeneity of underlying causes that make precise neurological diagnosis difficult.

Nevertheless, the biggest claim is trying to claim that some behavior/symptomology/quirk does not involve the brain.

> The diagnosis of these conditions are psychiatric, not neurological

Oh, I'm pretty new to this myself, but my understanding was that autism was considered a neurological disorder, not a psychiatric one. [1]

"Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders..."

1. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Educat...

So why is the diagnosis made by psychologists and psychiatrists, and not neurologists?

It definitely feels like that redefinition would be a difficult thing to use for any practical purpose.

Death redefined as a situation where people continue to have the ability to occupy space and don't require any food or oxygen.

Dead people don't have higher income insurance premiums. The neurodiverse do because they're more likely to have problems holding down a job.... Because people keep perpetuating a society that punishes difference.

Interesting. It's certainly a lighter way about talking about things but it does seem problematic from a pragmatic view. Likely it'd run into a wall when a person has more than one disorder (i.e. you can't composite things by listing them) or when the list of things that are affected is much shorter than the list that isn't (which should be the case for most folks).

"Neurodiversity" does sound like a thing to be encouraged, or at least not to be avoided/minimized. Do we really want more autism?

Autism is an extremely broad term. At one extreme, those who will never speak and spend their lives enraged by being unable to communicate. At the other, a very substantial fraction of the worlds finest science & engineering minds.

I wouldn't mind a few more of the latter.

It's also true that a large portion of the high support needs cohort have other developmental disabilities. Autism is often co-diagnosed but doesn't account for the entirety of that demographic.

you see, mentally right now choosing between neurodiversity and selection you voted for selection.

Okay, fair enough: that was a shit way for me to make a point.

There's nothing wrong with preferring that people have the ability to communicate with others (vs them not having that ability).

The moral issue is externally-enforced selection (AKA eugenics), which seems to persistently rear its ugly head as soon as you start talking about disability.

My friend (edit: redacted) chose not to have kids, because every ancestor he could trace on his paternal line had died of cancer around age 40, and he didn't think it was fair to inflict that on somebody else. I think that was a wise and moral choice - but it would not be wise or moral to take the choice away from him.

Wouldn't it be justified to find a family member in his family tree that did not follow this "rule of thumb"?

Then you merely have to marry someone from that same family.

Or just marry a single mother who already has children.

How’s he doing on the cancer front so far?

He's made it to 50 via monthly blood tests, early intervention & staying extremely fit. Has still had more than his share of chemotherapy though.

We certainly want to be more welcoming and accommodating to autistic people, even we don't want to forcibly induce more autism in people.

"Neurodiversity" and "Neurodivergence" are browser terms than "autism".

And calling any single person "diverse" is icky.

At no point in my comment did I imply anything to the contrary. "things like autism" does not refer to autism exclusively nor to a person.

How about a list of people who have/had it:

Tim Burton – Movie Director / Lewis Carroll – Author of “Alice in Wonderland” / Charles Darwin – Naturalist, Geologist, and Biologist / Emily Dickinson – Poet / Albert Einstein – Scientist & Mathematician / Bobby Fischer – Chess Grandmaster / Bill Gates – Co-founder of the Microsoft Corporation / Temple Grandin – Animal Scientist / Thomas Jefferson – Early American Politician / Steve Jobs – Former CEO of Apple / Stanley Kubrick – Film Director / Barbara McClintock – Scientist and Cytogeneticist / Michelangelo – Sculptor, Painter, Architect, Poet / Wolfgang Amadeus Mozart – Classical Composer / Sir Isaac Newton – Mathematician, Astronomer, & Physicist / Nikola Tesla – Inventor / Andy Warhol – Artist

https://www.appliedbehavioranalysisprograms.com/historys-30-...

I'm sorry, but this hand-picked list of exceptional people with light symptoms of ASD is minimizing a spectrum that includes some very serious disorders. Bringing out Bill Gates, with speculated mild Asperger's, is simply not a reasonable argument that "ASD can be good".

For perspective: Arguing "I know I guy who needs to squint to see things that are far away but he's an amazing pianist" doesn't add to a discussion about early detection of vision impairment and vision loss.

You may discount the entirety of positives, but there are, in fact, positives. This does in no way minimize the severe cases, rather simply contends ASD is not always negative, which was your original concern.

I cannot agree with your perspective comparison. Vision many help someone learn piano more quickly at first, but is immaterial to their maximum ability as a pianist. A better comparison is early detection of the development of additional fingers or exceptionally large hands (example: Rachmaninoff), both of which directly and permanently affect a person's ability to play difficult piano pieces. This too would be a concerning eugenics issue.

The ability to focus more deeply than the general population is quite valuable in a world where technological progress requires increasing specialisation.

Can you continue your line of thought? This ability, which is extremely rare, is quite valuable. What's the next step, the conclusion?

It’s also one of the diagnostic criteria for ASD, one that almost all autistic people share.

They typically can’t deliberately choose the subject of the focus, but it’s usually the case that any bit of deep knowledge is useful for something.